The Feds Remove Medicare Scams That Fear The Virus

The Justice Department is announcing charges against more than a dozen people from Florida to California in a series of Medicare scandals that fear bill of billions of dollars in bogus claims.

“These plans, we constantly see them evolving to another level,” said Assistant Inspector General Chris Schrank for investigations with the Department of Health and Human Services. “At a time when most Americans were pulled together … a small percentage of individuals have decided to steal from valuable programs for those who need them the most.”

Wednesday’s allegations date back to the early months of the pandemic, when there was still high demand for COVID tests in short supply. In addition, Medicare loosened its restrictive policies on telemedicine consultations, to keep older patients out of medical offices where the virus can spread. And the government had started pumping billions in special “provider relief” payments to help hospitals and doctors’ offices remain solvent. Scam artists, big and small, allegedly took advantage of all those situations.

The plans have shifted recently, and those that are popping up include fake vaccination cards bearing the likeness of the official HHS logo, Schrank said.

Among the accusers:

—— Michael Stein and Lionel Paltnik of Palm Beach County, Florida, who were charged in connection with a $ 73 million conspiracy to defraud and pay the government and receive a comeback. Stein owns a consulting company. Paltnick owns a Texas company which in turn owns and operates testing laboratories in Dallas and elsewhere. Federal prosecutors accused telehealth practitioners of engaging in a conspiracy to provide access to Medicare recipients for whom they could bill consultations. In return, physicians will reportedly send patients to Palatnik’s company-owned laboratories for expensive and unnecessary genetic tests for cancer and heart problems.

—— Dr. Alexander Baldonado of Queens, New York, on whom officials allegedly had access to Medicare recipients in a program advertising the virus test. Baldonado is accused of using patients’ medical information to order unnecessary genetic testing for cancer. The Department of Justice said Medicare was billed approximately $ 2 million as a result of it.

It was not clear whether the accused had lawyers who could comment on their behalf.

Relating to the fraud investigation, Medicare was taking action against about 50 physicians involved in various schemes.

Fraud against government health care programs is a widespread problem that costs taxpayers billions of dollars annually. The exact range is unknown.

Experts say part of the problem is that Medicare requires medical bills to be paid promptly, which means money often runs out before potential fraud can be flagged. Investigators say “pay and chase.”

In recent years, Medicare has tried to adopt technologies used by credit card companies to avoid fraud. Law enforcement coordination has increased with strike forces from state counterparts specializing in health care investigations, as well as federal prosecutors and agents.

Wednesday’s allegation comes a little more than a week after Attorney General Garland ordered the establishment of a special task force dedicated to combating widespread COVID-19 fraud. The task force was designed to bring together Justice Department resources against pandemic-related fraud with other government agencies, Garland said in a memo to senior department officials.

The department has brought a number of cases in recent months focusing on COVID-19 fraud, including one to receive millions in unemployment insurance benefits established through epidemic aid programs against eight people in New York City earlier this month He was accused of running the plan.

The new task force, led by Deputy Attorney General Lisa Monaco, will look for trends and investigate past enforcement actions, in addition to efforts to investigate and prosecute criminals in the US and internationally.

“Many of the health care fraud schemes charged today describe theft from American taxpayers through the exploitation of a national emergency,” Monaco said. “We are committed to holding the beneficiaries of such programs accountable to the fullest extent of the law.”


AP author Michael Balsamo contributed to this report.


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